Evaluation of Service-Quality Dimensions during Antenatal care in Primary Health Care Centers, Southern Kaduna Senatorial District, Nigeria

Shortage of qualified health care providers, weak health systems characterized by deficiencies of functioning equipment and essential medications, attitude of health workers as well as a range of physical, cultural, and financial barriers have been implicated for inaccessibility of quality care to many women. Poor acceptance of antenatal care is due to pervasive poverty, subordinate role of women, low literacy levels and the non-existent social systems in most developing countries. A cross-sectional, descriptive research design was used and a total of 296 respondents (pregnant women) who met the inclusion criteria participated in the study. A multistage sampling technique was used in selecting the required facilities and sample were selected in proportion with the inflow of clients in the facilities. Data were collected with the aid of questionnaires adapted from  Parasuraman etal (1988) and mean of 2.5 was used to ascertain satisfaction on the Likert scales. PHCs in southern Kaduna Senatorial district arevery accessible to the Clients (2.574±0.540) both financially and geographically as well as the opening hours of the clinics. The Clients have full confidence in the health care givers (2.977±0.483). Clients were satisfied with the level of empathy exhibited by the health care givers toward them during antenatal care (3.346±0.688) and that PHCs Centres' care was reliable (3.017±0.346). The mean score (3.043±0.375) shows satisfaction with the responsiveness of the Health care givers to the need of the Clients' during ANC. Clients were satisfied with the general appearance of the health facilities (3.103±0.364). Keywords: Evaluation, Service, Quality, Dimensions, Antenata

The practice of hepatocellular cancer surveillance in Nigeria

Background: Hepatocellular cancer is a disease of global and public health importance due to the widespread distribution of risk factors and associated high case fatality. Hepatocellular Cancer (HCC) in Sub-Saharan Africa is commonly seen among the younger age groups (<45 years) who present mostly in the terminal stage, when the disease is not amenable to any curative therapy. Hepatocellular Carcinoma surveillance employs the use of simple, cheap and readily available investigations, to detect early curable cancer in individuals with risk factors for HCC.Objectives:The aim of this study is to assess the practice of hepatocellular cancer screening among physicians.Methodolgy:This is a nationwide online survey carried out among physicians who care for patients with HCC. A questionnaire was sent out via a web link to all consenting doctors in Nigeria. The responses were collated in a cloud-based application and data was analysed using Epi-info version 20.Results:Atotal of 218 respondents, 142 were males (65.1 %) with a mean age of 37.6 ± 5.7 years. The modal age group was 31-40 years 153 (69.5%). The main factors considered as a hindrance to surveillance were; the cost of the tests (57.7%), failure of return of patients (50.5%) and not being aware of a surveillance program (45.2 %). The majority of the respondents were Gastroenterologists and Family Physicians. 54% of the gastroenterologists and 64% of the family physicians have never offered HCC surveillance to their patients.Conclusion:This survey highlights a knowledge gap in HCC surveillance among physicians. There is a need to make HCCsurveillance a daily routine among patients at risk by all physicians. Keywords: Surveillance, Hepatocellular Carcinoma, HBV, HCV, Cancer screening